Early Versus Late Surgery in Patients With Intestinal Behçet Disease

Abstract

To date, no studies have been conducted to evaluate the potential benefits of early surgery in patients with intestinal Behçet disease. We investigated the long-term clinical outcomes in patients with intestinal Behçet disease first diagnosed at surgery ("early surgery") compared with those requiring surgical resection during the course of the disease ("late surgery"). This is a retrospective cohort study. This study was conducted at a single tertiary academic medical center. We reviewed the medical records of 272 consecutive patients with intestinal Behçet disease between March 1986 and August 2010. The cumulative probabilities of clinical recurrence and reoperation after operation were the main outcomes measures. Forty of 272 patients were first diagnosed with intestinal Behçet disease at surgery (early surgery); the remaining 232 were diagnosed clinically, with 62 undergoing surgery during their follow-up after clinical diagnosis (late surgery). The cumulative probabilities of postoperative clinical recurrence and reoperation were significantly lower in the early-surgery group than in the late-surgery group (p = 0.045 and p = 0.003). In multivariate analysis, early surgery was the only independent factor significantly associated with a reduced probability of reoperation (HR 0.26; 95% CI 0.10-0.71; p = 0.008). However, when we analyzed only the patients who underwent surgery because of chronic symptoms, early surgery was not associated with lower cumulative clinical recurrence and reoperation rates (p = 0.896 and p = 0.492). We analyzed the clinical characteristics retrospectively, and the number of patients was insufficient to reach a decisive conclusion. : According to the current study, the patients with intestinal Behçet disease undergoing early surgery showed better prognoses in comparison with those undergoing late surgery. Early surgery may represent a valid approach in the initial management of the patients with intestinal Behçet disease, at least in the subset of the patients with acute symptoms.